Phoenix, Ariz.-based Banner Health and Aetna formed a new company, the Arizona Republic reported. Building on their ACO collaboration that dates back to 2011, Banner|Aetna will offer health insurance to employers in Maricopa and Pinal Counties. Banner|Aetna customers will have access to the Banner Health Network, which includes more that 900 primary-care doctors, 5,800 specialists, 125 urgent-care centers and 14 hospitals in Maricopa County. Patients traveling outside of Phoenix will have access to Aetna's network of providers. Banner officials told the Arizona Republic that Banner|Aetna will expand efforts used in the Banner-Aetna ACO, which currently includes 48,000 participants.
Dallas-based Tenet Healthcare is scaling back its insurance business in 2017 in response to approximately $20 million in unanticipated losses, DallasNews.com reported. The company, which is the third-largest for-profit hospital chain in the U.S., made the announcement during a conference call with analysts in which it reported lower-than-expected third-quarter earnings. Tenet had a net loss of $9 million for the quarter, compared with a net loss of $28 million in last year’s third quarter. The company will maintain its health plans in Illinois and California, but those in Texas, Arizona and Michigan are being sold.
Aledade’s primary care ACO network is twice the size it was at the beginning of 2016. It now has more than 200 independent, physician-led practices in 15 states and covers approximately 200,000 patients. Formed in June 2014, the Bethesda, Md.-based company partners with independent primary care physicians to help them make the shift to a value-based health care system. In 2015, Aledade ACOs had an average practice increase in preventive care visits of 251 percent and an average practice increase in transitional care services of 175 percent
Collectively, 17 Anthem Blue Cross ACOs in California generated $70.4 million in savings during a measurement period that lasted 12 months for each ACO. Because the ACOs had staggered launch dates throughout 2014, the savings were calculated by comparing each ACO’s cost trend during the measurement period against the ACO’s cost trend for the previous 12 months. Most of the ACOs also improved on several quality metrics when compared with their baseline measurements. The 17 ACOs cover more than 450,000 Anthem PPO members.
Cigna Corp. reversed its earlier decision to expand its individual plan offerings on the ACA Marketplace into three additional states. Cigna and Anthem both said in July they would increase their participation in the state exchanges. Some speculated that the expansion announcements were an attempt to encourage the Department of Justice to drop its lawsuit to block the proposed merger between the two insurers, but the government has not changed its stance.
An EpiPen alternative could soon be available. Kaleo Pharmaceuticals intends to begin selling the Auvi-Q epinephrine auto-injector again in 2017. Sanofi pulled Auvi-Q from the market in October 2015 in response to reports that the device did not consistently deliver a reliable dose. Kaleo, which invented Auvi-Q, bought the rights to the product back from Sanofi earlier this year. Kaleo says it has fully automated the device’s manufacturing process and has implemented a comprehensive quality control inspection to ensure proper dosing. Mylan has been under intense scrutiny in recent months for repeatedly increasing the price of its EpiPen.
Community Health Systems recorded a third-quarter loss of $79 million, compared with a profit of $52 million in the third quarter of 2015. During a conference call with analysts to discuss the quarterly earnings, CEO Wayne Smith revealed that CHS has seven transactions in the works to divest additional assets and further reduce the company’s $14.9 billion debt load. The transactions include the sale of 17 hospitals, along with home health care and nonhospital real estate assets. Smith said the transactions are expected to generate $1.2 billion in working capital.